Active NPI
Johnneisha Jackson
- Behavior Analyst
- Deerfield BCH, FL
National Provider Identifier
1760155212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 500 Fairway Dr
Deerfield BCH, FL 33441-1814 - Phone
- (954) 546-1188
- NPI assigned
- Jul 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
500 Fairway Dr
Deerfield BCH, FL 33441-1814
Mailing address
1055 E Colorado Blvd Ste 560
Pasadena, CA 91106-2380
Other practice location 1
25115 stanford ave suite a100
valencia, CA 91355
Phone (818) 241-6780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1760155212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 E COLORADO BLVD STE 560",
"city": "PASADENA",
"state": "CA",
"postal_code": "911062380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 FAIRWAY DR",
"city": "DEERFIELD BCH",
"state": "FL",
"postal_code": "334411814",
"telephone_number": "954-546-1188"
}
],
"practiceLocations": [
{
"address_1": "25115 stanford ave suite a100",
"address_purpose": "LOCATION",
"city": "valencia",
"state": "CA",
"postal_code": "91355",
"country_code": "US",
"telephone_number": "818-241-6780",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "JOHNNEISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-30",
"last_updated": "2021-07-30",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield BCH, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.